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Published February 2023 | Published
Journal Article Open

Investigating Deep Brain Stimulation of the Habenula: A Review of Clinical Studies

Abstract

Objectives. The aim of this study was to examine the current scientific literature on deep brain stimulation (DBS) targeting the habenula for the treatment of neuropsychiatric disorders including schizophrenia, major depressive disorder, and obsessive-compulsive disorder (OCD). Materials and Methods. Two authors performed independent data base searches using the PubMed, Cochrane, PsycINFO, and Web of Science search engines. The data bases were searched for the query ("deep brain stimulation" and "habenula"). The inclusion criteria involved screening for human clinical trials written in English and published from 2007 to 2020. From the eligible studies, data were collected on the mean age, sex, number of patients included, and disorder treated. Patient outcomes of each study were summarized. Results. The search yielded six studies, which included 11 patients in the final analysis. Treated conditions included refractory depression, bipolar disorder, OCD, schizophrenia, and major depressive disorder. Patients with bipolar disorder unmedicated for at least two months had smaller habenula volumes than healthy controls. High-frequency stimulation of the lateral habenula attenuated the rise of serotonin in the dorsal raphe nucleus for treating depression. Bilateral habenula DBS and patient OCD symptoms were reduced and maintained at one-year follow up. Low- and high-frequency stimulation DBS can simulate input paths to the lateral habenula to treat addiction, including cocaine addiction. More data are needed to draw conclusions as to the impact of DBS for schizophrenia and obesity. Conclusions. The habenula is a novel target that could aid in reducing neuropsychiatric symptoms and should be considered in circuit-specific investigation of neuromodulation for psychiatric disorders. More information needs to be gathered and assessed before this treatment is fully approved for treatment of neuropsychiatric conditions.

Additional Information

© 2022 Published by Elsevier Inc. on behalf of the International Neuromodulation Society. Under a Creative Commons license - Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Authorship Statements. Mickey E. Abraham was responsible for the study conception, data acquisition, analysis, interpretation, drafting the work, revising the work, and approving the final version of the work. Vera Ong was responsible for data acquisition, analysis, interpretation, drafting the work, revising the work, and approving the final version of the work. Nolan J. Brown was responsible for the study analysis, interpretation, drafting the work, revising the work, and approving the final version of the work. Elliot H. Choi was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Nathan A. Shlobin was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Chen Yi Yang was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Shane Shahrestani was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Alexander S. Himstead was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Donald K. Detchou was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Neal Patel was responsible for analysis, revising the work, and approving the final version of the work. Julian Gendreau was responsible for analysis, revising the work, approving the final version of the work. Justin Gold was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Ronald Sahyouni was responsible for acquisition, analysis, revising the work, and approving the final version of the work. Luis D. Diaz-Aguilar was responsible for acquisition and analysis. Sharona Ben-Haim was responsible for study conception, interpretation, drafting the work, revising the work, and approving the final version of the work. All authors approved the final version of the manuscript. The authors reported no sources of funding for this work. The authors reported no conflicts of interest.

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Created:
August 22, 2023
Modified:
October 24, 2023